Which are the Best Health Metrics to Track For Longevity?

Which are the Best Health Metrics to Track For Longevity?

  1. There is a growing interest in using technology and testing to track detailed health and longevity metrics. Through advances like fitness watches and direct-to-consumer lab testing, more individuals are monitoring biomarkers tied to longevity and wellbeing.

This quantified-self movement allows personalized health tracking and optimization based on real-time data. While an annual physical provides a snapshot, regular tracking of additional aging biomarkers gives a more nuanced view of your healthspan.

This enables proactive management of factors tied to longevity. In this post, we'll explore some of the key health and aging metrics you should track consistently if you want to maximize your lifespan through a quantified approach.

Cardiorespiratory Fitness

What is VO2 max and why is it important?

Your VO2 max or cardiorespiratory fitness level is one of the strongest predictors of mortality risk and longevity. VO2 max measures the maximum amount of oxygen your body can utilize during intense exercise and reflects the efficiency of your cardiovascular system.

How is VO2 max measured?

VO2 max can be directly measured by performing a maximal exercise test while breathing into a mask that analyzes oxygen and carbon dioxide levels. This test requires specialized equipment only found in clinical settings.

However, VO2 max can also be estimated using formulas based on performance in endurance activities. For example, your VO2 max can be approximated by timing how long it takes you to run 1 mile. There are various online calculators that provide VO2 max estimations based on running pace for 1 mile or other distances.

What is considered a good VO2 max?

A higher VO2 max is associated with lower all-cause mortality and reduced risk of heart disease, diabetes, and other chronic illnesses. A VO2 max above 35 ml/kg/min for women and 45 ml/kg/min for men is considered excellent. Elite athletes often have VO2 max levels in the 60-80 ml/kg/min range.

How often should VO2 max be tested?

Test your VO2 max at least annually to monitor any changes. Endurance athletes may want to test more frequently to track training progress.

Dr Peter Attia discusses the science behind longevity and VO2 Max

Body Composition

What are the best ways to measure body composition?

While BMI is commonly used, body composition (the ratio of fat mass to lean mass) is a more telling health indicator. Here is a good study which discusses the relationship between weight and body composition and longevity. The research found that maintaining a healthy weight through diet and physical activity should remain the cornerstone in the prevention of chronic diseases and the promotion of healthy ageing.

The most accurate methods for assessing body composition are:

  • DEXA (dual-energy X-ray absorptiometry) scan
  • Underwater weighing
  • Air displacement plethysmography (Bod Pod)
  • Bioelectrical impedance analysis (BIA)

DEXA scans and underwater weighing are considered gold standards but require specialized equipment. BIA scales and handheld devices offer a more accessible option.

What are healthy body composition ranges?

Ideally, body fat percentage should be in the 14-24% range for men and 21-31% range for women. Athletes and the elderly may fall outside these ranges and still be considered healthy. The key is to maintain higher lean mass and lower fat mass.

Why is body composition important for longevity?

Maintaining optimal body composition reduces your risk of obesity-related diseases like diabetes and heart disease. It also helps prevent sarcopenia - age-related loss of muscle mass and strength. Tracking body composition allows you to monitor fat loss versus muscle gain over time. In this study they found that lean body mass is a better metric for longevity than BMI.

How often should you measure body composition?

Test your body composition twice per year or more frequently if attempting to reduce body fat or increase muscle mass through diet and exercise. Monitor the trend over time. It is generally recommended to use skin calipers when measuring body composition, more can be found out in this health line article.

Blood Glucose and Insulin

This study is one of many promoting the relationship between insulin senstivity and life span. This particular study indicates family or genetic longevity is marked by enhanced insulin sensitivity and it compared healthy offspring of long-lived siblings to control subjects. The offspring had a familial predisposition for longevity. Insulin sensitivity strongly correlated with parental longevity - the older the parents lived, the higher the offspring's glucose disposal rate. The findings suggest familial longevity is marked by better maintenance of insulin sensitivity and glucose metabolism. This may be key to longer healthspans.
To potentially increase longevity, maintaining insulin sensitivity through diet, exercise and other lifestyle approaches appears crucial. Tracking biomarkers like fasting glucose and HbA1c can help monitor insulin sensitivity.

What do fasting glucose and insulin levels indicate?

Fasting blood glucose and insulin levels provide key insights into your metabolic health. Chronically elevated glucose and insulin increase your risk for type 2 diabetes, heart disease, fatty liver, and other age-related diseases.

When should these biomarkers be tested?

Get baseline fasting glucose and insulin tests first, then track these biomarkers every 3-6 months. Also test after making major diet and lifestyle changes to assess effects.

What are optimal fasting glucose and insulin levels?

Ideal fasting glucose is 70-99 mg/dL. Fasting insulin should be below 5 μU/mL. Higher levels indicate insulin resistance.

Why are glucose and insulin important longevity metrics?

Keeping fasting glucose and insulin in healthy ranges reduces your risk of metabolic diseases and optimizes longevity. Monitoring these key biomarkers allows you to assess the impact of nutrition and lifestyle interventions.

Inflammation Levels

How does inflammation impact longevity?

Inflammation worsens with age and underlies many chronic age-related diseases like cardiovascular disease, cancer, and Alzheimer’s. Controlling inflammation is key for healthy longevity.

Research Showing relationship between Inflammation and Longevity

In this review, Ferrucci and Fabbri look at the evidence on inflammageing, which refers to the chronic low-level inflammation that develops as we get older.

They explain that inflammageing is linked to higher risk of cardiovascular disease, cancer, dementia, depression, frailty, and earlier death. Potential causes include obesity, aging cells, impaired waste removal by cells, and gut bacteria changes. The authors argue inflammageing may induce a state of tissue breakdown that impairs repair and contributes to muscle loss and frailty.

They conclude that reducing inflammageing could help prevent cardiovascular disease while also slowing multiple chronic diseases, disability, and decline in late life. But more research is needed on whether anti-inflammatory treatments can improve non-heart conditions associated with aging.

What biomarkers indicate inflammation?

C-reactive protein (CRP) is an inflammatory biomarker that predicts heart disease risk and biological aging rates. Other options include homocysteine, fibrinogen, and cytokines like IL-6 and TNF-alpha.

What are optimal inflammation levels?

For CRP, optimal is below 1 mg/L, with 3 mg/L or above indicating high inflammation. Other inflammatory markers have their own reference ranges.

How often should inflammation be assessed?

Test CRP and other inflammatory biomarkers at least annually. More frequent testing allows assessing the impacts of interventions on inflammation.

Lipoprotein Profile

What does cholesterol particle testing involve?

Advanced lipid testing like NMR lipoprotein profile measures LDL particle number (LDL-P), size, and your triglyceride/HDL ratio. These provide a better assessment of heart disease risk than standard cholesterol panels.

Why test particle number and size?

The number and size of circulating LDL particles better predict heart health than total LDL or total cholesterol levels. Small dense LDL particles are particularly atherogenic.

Triglyceride/HDL ratio also indicates insulin resistance and heart disease risk. The optimal ratio is below 2.

How often should lipoprotein testing be done?

Initially, get a baseline NMR lipid profile. Then track annually, or more often if attempting to reduce cardiovascular risk through lifestyle, diet, or medication.


Nutrient Levels for Longevity

Which nutrients should you test for longevity?

Check levels of key micronutrients like vitamin D, omega-3s, and magnesium. Deficiencies in these nutrients are common and can hamper health and longevity.

How can testing guide supplementation for longevity?

Testing nutrient levels allows you to identify any deficiencies and personalize your supplementation regimen accordingly. Optimal intake of key nutrients can promote longevity.

How often should nutrient levels be checked?

Test micronutrient levels at least annually. More frequent testing may be needed if addressing a deficiency through increased intake.

Hormones for Longevity

How do hormone levels impact aging?

Declining levels of key hormones like growth hormone, testosterone, and DHEA contribute to many unwanted effects of aging. Maintaining youthful hormone profiles can help optimize longevity.

What’s the role of testing in hormone supplementation?

Testing hormone levels allows you to determine if supplementation is needed to restore optimal levels for your age and sex. Customizing hormone therapy based on testing is important for safety and efficacy.

Genetic Markers for Longevity

How can genetic testing guide longevity efforts?

Testing for high-risk gene variants like APOE4 and BRCA can help personalize your prevention efforts to reduce your risk of diseases like Alzheimer’s and cancer as you age.

What key genetic markers should be tested?

Some of the top genetic markers that provide actionable information for longevity include APOE, BRCA1/2, NADSYN1, and telomere length. Talk to your doctor about clinically appropriate genetic testing.

Heart Rate Metrics for Longevity

Why track resting heart rate (RHR) and heart rate variability (HRV)?

A lower RHR and higher HRV are associated with longevity. Checking these heart rate metrics daily provides insights into your nervous system balance and your body's resilience to stress.

What are optimal RHR and HRV ranges?

A RHR around 60 bpm is ideal for longevity. Optimal HRV depends on age but is generally higher. Improve these markers through lifestyle and exercise.

Well-being for Longevity

How does emotional health impact longevity?

Factors like life satisfaction, optimism, and purpose support resilience and have been linked to increased longevity. Assessments of emotional well-being provide insight into your mental fitness.

What simple assessments can you do?

Well validated questionnaires like the PERMA meter, Warwick-Edinburgh Mental Well-Being Scale, and Satisfaction With Life Scale take just minutes but provide valuable insights into well-being.


Optimizing longevity requires a comprehensive approach to self-tracking. The key health and aging metrics to monitor include VO2 max, body composition, fasting glucose and insulin, inflammation levels, cholesterol particles, nutrient levels, hormones, genetic markers, resting heart rate/HRV, and emotional well-being. Consistently tracking these biomarkers of aging (CRP, IGF-1, homocysteine, vitamin D, DHEA, testosterone, telomere length, APOE, BRCA, etc.) and longevity (VO2 max, glucose, insulin, body fat %, LDL-P, etc.) provides invaluable insights into your overall vitality and healthspan. Use this data to inform lifestyle, nutrition, and supplement strategies to extend your years of healthy life. The quantified-self approach outlined here will pay dividends through added longevity.

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